Models of surveillance of HIV/AIDS: updating the debate

Background: During the first 20 years of the AIDS epidemic in Brazil, the name-based compulsory notification has been the most important method for epidemiological surveillance (ES) and provided support to the National Response. Yet, several factors prevented such notification from being complete, and the information to have desired quality. It is considered this strategy as being worn out by abuse.
Methods: The aim of this study was to develop some reflections concerned to ES on HIV/AIDS, discuss hindrances and possibilities of change, based on the Brazilian experience on setting up a “Sentinel Surveillance Network of Centers for Testing and Counseling on HIV-AIDS”. The data collecting processes and those for the creation of this Sentinel Surveillance Network involving 156 Centers for Testing an d Counselling on STD/AIDS (CTC) contexts are the same.
Results: The strategy for the creation of this Sentinel Surveillance Netw ork - which uses a new HIS as its own source of information – should be based on the possibility of cooperation (“understanding”) considering reasoning and practices of surveillance and assistance obtained from the health care system itself. Not being worried about precise estimations of incidence or prevalence, it might be assumed a “special” source of information as its own basis, with enough motivation to participate using “common cooperative efforts”. Rather than the coverage, what minds here is the quality of the information provided. The HIV surveillance might come as a natural consequence of the implementation of the new HIS, conceived as a support for prevention activities, furthermore it should comprise the HIV surveillance system. Advantages included: the new HIS might offer the chance for monitoring infection levels and risk behavior within the high risk grou ps.
Conclusions: The non-compulsory adherence to the new HIS overcomes the low interest in recording. The quality of such elec tronic recording would depend mostly on the quality of the care given. It also might provide information as well as local data analysis , recovering the notion of ES as useful information tool for health action.